Parkinson's: The plight of the senior class

A famous scene from the movie Finding Private Ryan shows Tom Hanks, an Army Ranger captain looking over a map while holding a compass. As his men look on his hand begins to shake and the compass is literally rattling around in his hand.

In Hank's case, the shaking compass is probably just from the horrors of war, shell shock and the pressure that stress brings. But for real people in real life today, that shaking can reveal the beginnings of Parkinsons Disease.

Parkinson's is one of the diseases that afflicts more people over the age of 65 than it does younger adults.While the disease is not exclusive to senior citizens, the National Parkinson's Foundation notes that only 15 percent of Parkinson's diagnosis are in people under the age of 50.

When many people think of Parkinson's Disease, they can't help but think of former boxing great Muhammad Ali or actor Michael J. Fox, both of whom have publicly fought their battle with the disease for years. While it's common knowledge that both Ali and Fox are battling Parkinson's, the disease itself remains a mystery to many, including researchers working hard at understanding just what causes it.

Parkinson's Disease is a brain disorder that occurs when nerve cells in the brain break down. These nerve cells are responsible for producing an important chemical called dopamine, which sends signals to the part of the brain responsible for controlling movement. When these nerve cells are functioning properly, the dopamine enables the brain to let the body's muscles move smoothly and however the brain wants them to. But when these nerve cells break down, dopamine is not produced, thereby negatively affecting how the body moves. In essence, when these important nerve cells are damaged, the body makes movements on its own, without regard for how a person wants his or her body to move.

Unfortunately, the cause of Parkinson's Disease remains a mystery. While research efforts are ongoing, a concrete cause has yet to be determined. Some studies have suggested that abnormal genes are at the root of Parkinson's Disease, but ample proof does not yet exist to concretely show the disease is inherited.

What is known is that Parkinson's does not discriminate on the basis of sex, gender or ethnicity. A nearly equal amount of men and women have Parkinson's Disease, and estimates suggest that nearly 60,000 new cases are diagnosed each year. Those are in addition to the 1.5 million Americans who already have the disease.

Most people are aware that shaking and trembling are symptoms of Parkinson's Disease. This symptom is called tremor, and it can affect arms, legs, hands, or the head. While not everyone experiences tremors, it is one of the most common symptoms, in addition to being an early indicator of the disease, as it is the first symptom many patients notice prior to diagnosis. It's important to note as well that not everyone with a tremor has Parkinson's Disease. Typically, tremor will begin on just one side of the body, in an arm or leg. But because Parkinson's is a progressive disease, the symptoms will gradually (in most cases) get worse.

Other symptoms include slow movements, problems with balance or walking, and stiffening of the muscles. Over time, Parkinson's can affect muscles throughout the body, perhaps leading to difficulty swallowing and trouble speaking, among other things.

It's typical for symptoms of Parkinson's Disease to start manifesting themselves between the ages of 50 and 60, though symptoms can start earlier in some people.

Diagnosing Parkinson's can be difficult, as there is no blood test or other method that can confirm the disease. A neurological exam, including tests and questions aimed at seeing how well the brain's nerves are working, are conducted. These tests can include checking muscle strength and reflexes, checking vision, and watching how a person moves.

Because some other diseases have similar symptoms as Parkinson's Disease, a doctor might suggest a blood test or MRI to rule out other diseases. These tests, for instance, could reveal signs of stroke or brain tumor.

Treatment can depend on the degree of the symptoms. If symptoms are not affecting daily life, it's possible a doctor will wait to prescribe medicines until the symptoms begin to impact a person's quality of life.

The medicines used in treating Parkinson's can also depend on how advanced the disease is. Some medications have caused problems in patients who used them for long periods of time in high doses. That could lead a doctor to adjust medicines as the symptoms progress. The medicines used most commonly will attempt to mimic or replace dopamine, improving the tremor rigidity and slowness associated with the disease.

While Parkinson's is a progressive disease, meaning the symptoms will worsen over time, in general this progression is gradual. As a result, many people diagnosed with Parkinson's continue working for years, with minor adjustments here and there as the disease progresses. For some, symptoms do remain minor, and therefore have little impact on everyday life.

Unfortunately, depression is common among people with Parkinson's. However, many support groups do exist, as does counseling for both the afflicted and their families.

To learn more about Parkinson's Disease, visit the National Parkinson Foundation Web site at www.parkinson.org.

What is being done to find a cure?

The National Institute of Neurological Disorders and Stroke (NINDS) conducts PD research in laboratories at the National Institutes of Health (NIH) and also supports additional research through grants to major medical institutions across the country. Current research programs funded by the NINDS are using animal models to study how the disease progresses and to develop new drug therapies. Scientists looking for the cause of PD continue to search for possible environmental factors, such as toxins, that may trigger the disorder, and study genetic factors to determine how defective genes play a role. Other scientists are working to develop new protective drugs that can delay, prevent, or reverse the disease.